Health-Care Use by Frequent Marijuana Smokers Who Do Not Smoke Tobacco

Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098.
Western Journal of Medicine 07/1993; 158(6):596-601.
Source: PubMed


Even though marijuana smoke contains carcinogens and more tar than tobacco smoke and marijuana intoxication has been implicated as a risk factor for injuries, relatively little epidemiologic evidence has identified marijuana use as a risk factor for ill health. This study is the first to examine the health effects of smoking marijuana by comparing the medical experience of "daily" marijuana smokers who never smoked tobacco (n = 452) with a demographically similar group of nonsmokers of either substance (n = 450). Marijuana smoking status was determined during multiphasic health checkups at Kaiser Permanente medical centers between July 1979 and December 1985. Medical records were reviewed for as long as 2 years after the checkups. Frequent marijuana smokers had small increased risks of outpatient visits for respiratory illnesses (relative risk [RR] = 1.19; 95% confidence interval [CI] = 1.01, 1.41), injuries (RR = 1.32; CI = 1.10, 1.57), and other types of illnesses (RR = 1.09; CI = 1.02, 1.16) compared with nonsmokers; their risk of being admitted to a hospital was elevated but not statistically significant (RR = 1.51; CI = 0.93, 2.46). Analyses were adjusted for sex, age, race, education, marital status, and alcohol consumption. Daily marijuana smoking, even in the absence of tobacco, appeared to be associated with an elevated risk of health care use for various health problems.

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    • "Chronic use of cannabis also has adverse effects on pulmonary and cardiac health [3,7]. Survey evidence shows that frequent cannabis users (who do not smoke tobacco) are more likely to experience many of the respiratory problems that chronic tobacco smokers experience [8]. Many tobacco users also misuse cannabis, and vice versa [9,10]. "

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    • "Though cannabis has been suggested to have moderate overall effects on society (Nutt et al., 2011), studies have shown that cannabis use may be associated with impaired functional outcomes and mental health. It has been found to be associated with impaired educational attainment (Lynskey and Hall, 2000), reduced workplace productivity (Lehman and Simpson, 1992), motor vehicle accidents (National Highway Traffic Safety Administration, 2001), and impaired physical health (Polen et al., 1993). Reports have suggested that cannabis use may be associated with welfare dependence (Schmidt et al., 1998), reduced income (Degenhardt et al., 2007) and impaired interpersonal relationships (Newcomb and Bentler, 1988). "
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    • "Our standard economic framework is based on the premise that individuals do not consume health care for immediate pleasure but rather for the effect that health care has on health status and, consequently, on overall utility or wellbeing (Grossman 1999; Phelps 2002). Illicit drug use is expected to affect health care utilization by causing increased health problems (see previous section), which would normally lead to increased demand for health care (e.g., Mor et al. 1992; Polen et al. 1993; Cherpitel 1999, 2003; French et al. 2000a; McGeary and French 2000; Kushel et al. 2002; Masson et al. 2004). Under this framework, the derived demand for health care is given by HC ¼ fðH ðD; X Þ; X Þ ð 1Þ where HC is a measure of health care utilization (e.g., ER visits, inpatient hospital days), H denotes health problems, D refers to illicit drug use, and X captures individual characteristics that affect the consumption of health care "
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